scholarly journals The transition in the etiologies of hepatocellular carcinoma-complicated liver cirrhosis in a nationwide survey of Japan

2020 ◽  
Author(s):  
Hirayuki Enomoto ◽  
◽  
Yoshiyuki Ueno ◽  
Yoichi Hiasa ◽  
Hiroki Nishikawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Viral Hepatitis ◽  
Real Number ◽  
Nationwide Survey ◽  
Hcv Infection ◽  
Annual Number ◽  
The Real ◽  
Number Of Patients ◽  
Viral Etiologies

Abstract Background We recently reported the real-world changes in the etiologies of liver cirrhosis (LC) based on nationwide survey data and assessed the etiologies of LC with hepatocellular carcinoma (HCC). Methods Fifty-five participants from 68 institutions provided data on 23,637 patients with HCC-complicated LC. The changing trends in etiologies were assessed. We further analyzed the data from 29 hospitals that provided the annual number of newly identified HCC-complicated LC patients from 2008 to 2016 (N = 9362) without any missing years and assessed the transition in the real number of newly identified HCC-complicated LC cases. Results In the overall cohort, hepatitis C virus (HCV) infection (60.3%) and hepatitis B virus (HBV) infection (12.9%) were the leading and third-most common causes of HCC-complicated LC in Japan, respectively. HCV infection was found to be the leading cause throughout Japan. The rate of viral hepatitis-related HCC decreased from 85.3 to 64.4%. Among non-viral etiologies, notable increases were observed in nonalcoholic steatohepatitis (NASH)-related HCC (from 1.5 to 7.2%) and alcoholic liver disease (ALD)-related HCC (from 8.5 to 18.6%). Regarding the real number of newly diagnosed patients, the number of patients with viral hepatitis-related HCC decreased, while the number of patients with non-viral HCC, particularly NASH-related HCC, increased. Conclusions Viral hepatitis has remained the main cause of HCC in Japan. However, the decrease in viral hepatitis-related HCC, particularly HCV-related HCC highly contributed to the etiological changes. In addition, the increased incidence of non-viral HCC, particularly NASH-related HCC, was involved in the changing etiologies of HCC-complicated LC in Japan.

scholarly journals Transition in the etiology of liver cirrhosis in Japan: a nationwide survey

2019 ◽  
Vol 55 (3) ◽  
pp. 353-362 ◽  
Author(s):  
Hirayuki Enomoto ◽  
◽  
Yoshiyuki Ueno ◽  
Yoichi Hiasa ◽  
Hiroki Nishikawa ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Viral Hepatitis ◽  
Nationwide Survey ◽  
Newly Diagnosed ◽  
Japan Society ◽  
Real Numbers ◽  
The Real ◽  
Changing Trends ◽  
Notable Increase ◽  
Viral Etiologies

Abstract Background To assess the recent real-world changes in the etiologies of liver cirrhosis (LC) in Japan, we conducted a nationwide survey in the annual meeting of the Japan Society of Hepatology (JSH). Methods We investigated the etiologies of LC patients accumulated from 68 participants in 79 institutions (N = 48,621). We next assessed changing trends in the etiologies of LC by analyzing cases in which the year of diagnosis was available (N = 45,834). We further evaluated the transition in the real number of newly identified LC patients by assessing data from 36 hospitals with complete datasets for 2008–2016 (N = 18,358). Results In the overall data, HCV infection (48.2%) was the leading cause of LC in Japan, and HBV infection (11.5%) was the third-most common cause. Regarding the transition in the etiologies of LC, the contribution of viral hepatitis-related LC dropped from 73.4 to 49.7%. Among the non-viral etiologies, alcoholic-related disease (ALD) and nonalcoholic steatohepatitis (NASH)-related LC showed a notable increase (from 13.7 to 24.9% and from 2.0 to 9.1%, respectively). Regarding the real numbers of newly diagnosed patients from 2008 to 2016, the numbers of patients with viral hepatitis-related LC decreased, while the numbers of patients with non-viral LC increased. Conclusions HCV has remained the main cause of LC in Japan; however, the contribution of viral hepatitis as an etiology of LC is suggested to have been decreasing. In addition, non-viral LC, such as ALD-related LC and NASH-related LC, is suggested to have increased as etiologies of LC in Japan.

scholarly journals Metabolic Alterations Associated with Early-Stage Hepatocellular Carcinoma and Their Correlation with Aging and Enzymatic Activity in Patients with Viral Hepatitis-Induced Liver Cirrhosis: A Preliminary Study

2020 ◽  
Vol 9 (3) ◽  
pp. 765
Author(s):  
Chung-Man Moon ◽  
Sang Soo Shin ◽  
Suk Hee Heo ◽  
Yong Yeon Jeong
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Lactate Dehydrogenase ◽  
Enzymatic Activity ◽  
Viral Hepatitis ◽  
Potential Risk ◽  
Early Stage ◽  
Liver Parenchyma ◽  
Cirrhotic Liver ◽  
1H Mrs

Liver cirrhosis (LC) can develop hepatocellular carcinoma (HCC). However, noninvasive early diagnosis of HCCs in the cirrhotic liver is still challenging. We aimed to quantify the hepatic metabolites in normal control (NC), cirrhotic liver without HCC, cirrhotic liver with HCC (CLH), and early-stage HCC groups using proton magnetic resonance spectroscopy (1H-MRS) with a long echo-time (TE) and to assess the potential association between the levels of hepatic metabolites in these four groups and aging and enzymatic activity. Thirty NCs, 30 viral hepatitis-induced LC patients without HCC, and 30 viral hepatitis-induced LC patients with HCC were included in this study. 1H-MRS measurements were performed on a localized voxel of the normal liver parenchyma (n = 30) from NCs, cirrhotic liver parenchyma (n = 30) from LC patients without HCC, and each of the cirrhotic liver parenchyma (n = 30) and HCC (n = 30) from the same patients in the CLH group. Generalized estimating equations were used to evaluate potential risk factors for changes in metabolite levels. Potential associations between metabolite levels and age and serum enzymatic activities were assessed by correlation analysis. The levels of lactate+triglyceride (Lac+TG) and choline (Cho) in HCC were significantly higher compared to those in LC and CLH. A potential risk factor for changes in the Lac+TG and Cho levels was age, specifically 60–80 years of age. In particular, the Lac+TG level was associated with a high odds ratio of HCC in males aged 60–80 years. The Lac+TG and Cho concentrations were positively correlated with lactate dehydrogenase and alkaline phosphatase activities, respectively. Our findings suggested that 1H-MRS measurement with a long TE was useful in quantifying hepatic Lac+TG and Cho levels, where higher Lac+TG and Cho levels were most likely associated with HCC-related metabolism in the viral hepatitis-induced cirrhotic liver. Further, the level of Lac+TG in HCC was highly correlated with older age and lactate dehydrogenase activity.

scholarly journals Hepatocellular carcinoma in Brazil: report of a national survey (Florianópolis, SC, 1995)

1997 ◽  
Vol 39 (3) ◽  
pp. 165-170 ◽  
Author(s):  
Carlos S. GONÇALVES ◽  
Fausto E. L. PEREIRA ◽  
Luis C.C. Gayotto
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Rio De Janeiro ◽  
Minas Gerais ◽  
Sao Paulo ◽  
Alpha Fetoprotein ◽  
Hcv Infection ◽  
Etiological Factors ◽  
Medical Centers ◽  
Espirito Santo

In order to investigate epidemiological aspects of hepatocellular carcinoma (HCC) in Brazil, basic informations about cases diagnosed from January 1992 to December 1994 were requested to several medical centers of different Brazilian States. A simple questionnaire included age, sex, alcohol abuse (over 80g/day), associated liver cirrhosis, persistent HBV infection (HBsAg), HCV infection (anti-HCV) and serum levels of alpha fetoprotein. 287 cases, over 16 years old, from 19 medical centers of 8 States (Pará, Bahia, Minas Gerais, Espirito Santo, Rio de Janeiro, São Paulo, Paraná and Rio Grande do Sul) were analysed. The results showed: (a) Mean age was 56.3 ± 14.4 for men and 54.7 ± 16.8 yr for women and the male/female ratio was 3.4:1. (b) 69.6% were caucasians, 21.8% mullatoes, 4.8% orientals and 3.7% blacks. (c) HBsAg (+) in 77/236 cases (41.6%) without differences between males and females. (d) Anti-HCV (+) in 52/193 cases (26.9%). (e) 7/180 cases were positive both for HBsAg and anti-HCV (3.8%). (f) There was chronic alcoholism in 88/235 cases (37%). (g) HCC was found in cirrhotic livers in 71.2% of 202 cases in which the presence or absence of cirrhosis was reported. (h) Alpha-fetoprotein above 20 ng/ml was found in 124/172 cases (72%) and above 500 ng/ml only in 40 cases (23.2%). These results showed that the HCC in Brazil has an intermediate epidemiological pattern as compared to those from areas of low and high incidence of the tumor. In spite of the high frequency of the association of HCC with the HBV and/or HCV infections, 42% of 180 cases were negative both for HBsAg and anti-HCV, indicating the possible role of other etiological factors. The comparison of data from different States showed some regional differences: higher frequency of associated HBsAg in Pará, Bahia, Minas Gerais and Espírito Santo, higher frequency of associated HCV infection in Rio de Janeiro, São Paulo and States of the Southern region and low frequency of associated liver cirrhosis in Salvador and Rio de Janeiro (55.5 and 50% respectively). Further investigation will be necessary to study the presence of other possible etiological factors as aflatoxins, suggested by the favourable climatic conditions for food contamination by fungi in the majority Brazilian regions

scholarly journals 1261Epidemiology of Kawasaki disease in Japan, 2017–2018: results from the nationwide survey

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Ryusuke Ae ◽  
Nobuko Makino ◽  
Koki Kosami ◽  
Yuri Matsubara ◽  
Yosikazu Nakamura
Keyword(s):  
Kawasaki Disease ◽  
Large Scale ◽  
Nationwide Survey ◽  
Developed Countries ◽  
Annual Number ◽  
Cardiac Complications ◽  
Large Scale Data ◽  
Number Of Patients ◽  
Using Data ◽  
Epidemiologic Characteristics

Abstract Background Kawasaki disease (KD) is the most common cause of acquired pediatric heart disease in developed countries. The study aimed to summarize the epidemiologic characteristics, treatments, and cardiac complications of KD, using data from the nationwide survey in Japan. Methods The nationwide survey in Japan has been conducted biennially since 1970. The survey respondents were hospitals specializing in pediatrics and those with ≥100 beds and a pediatric department throughout Japan, where KD patients were eventually hospitalized. The most recent survey was completed in 2019, obtaining information for patients who developed KD during 2017–2018. Results The survey identified 32528 KD patients, which comprised 15164 (47%) in 2017 and 17364 (53%) in 2018. The highest annual incidence rate was recorded in 2018 (359 per 100,000 children aged 0–4 years). After 1982, patients with ≤4 principal KD signs increased, resulting in 6847 (21%) patients diagnosed during 2017–2018. Among 30784 patients who received initial intravenous immunoglobulin administration, 6061 (20%) did not respond. Within 30 days of KD onset, 9.0% of patients were diagnosed with cardiac complications, and consequently, 2.6% of patients developed cardiac sequelae after the acute illness. Conclusions The annual number of patients developing KD in Japan increased from 1970 through 2018, while the proportion of KD patients with cardiac complications decreased. Recent advances in KD treatments might have contributed to preventing the development of cardiac complications. Key messages We analyzed large-scale data and summarized the epidemiologic characteristics, treatments, and cardiac complications of KD in Japan.

Abstract WMP98: A Nationwide Study of Non-traumatic Intracranial Hemorrhage in Patients Receiving Direct Oral Anticoagulant Therapy: J-Aspect Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ryota Kurogi ◽  
Kunihiro Nishimura ◽  
Akiko Kada ◽  
Satoru Kamitani ◽  
Kuniaki Ogasawara ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Oral Anticoagulant Therapy ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Nationwide Survey ◽  
Annual Number ◽  
Prescription Data ◽  
Nationwide Study ◽  
Number Of Patients ◽  
Traumatic Intracranial Hemorrhage

Background and purpose: The incidence of non-traumatic intracranial hemorrhage (ICH) during treatment with direct oral anticoagulants (DOACs) is lower than that during warfarin treatment. The characteristics of intracranial hemorrhage during DOAC therapy, however, remain unclear. Therefore, we performed a nationwide survey in Japan to examine the clinical characteristics and outcomes of DOAC-associated ICH using data obtained from the Japanese Diagnosis Procedure Combination (DPC)-based Payment System. Methods: We analyzed the data of 1,567 patients with ICH (DOAC-associated ICH, 88; warfarin-associated ICH, 1,479) who were urgently hospitalized at 575 institutions across Japan from April 2010 to March 2013 for whom prescription data before admission were available. Results: The annual number of patients with all anticoagulant (DOAC or warfarin)- associated ICH in each year from 2010 to 2013 was 226, 252, 426, and 663, representing 15.7%, 15.4%, 16.1%, and 16.1% of all ICH cases in the same period, respectively. There was an increase in the proportion of patients who presented with DOAC-associated ICH in all anticoagulant-associated ICH in each year from 2010 to 2013 (0%→0.4%→3.8%→10.7%). The proportion of patients with impaired consciousness (three-digit score on Japan Coma Scale) at admission (DOAC, 19.3%; Warfarin, 25.4%; P=0.20), in-hospital mortality within 7 days (DOAC, 11.4%; Warfarin, 19.5%; P=0.06), and mRS score of 5-6 at discharge (DOAC, 27.3%; Warfarin, 37.4%; P=0.06) were lower in the patients with DOAC-associated ICH. The rates of surgery for hematoma removal were significantly lower in the patients with DOAC-associated ICH (NOAC, 2.3%; Warfarin, 9.7%; P=0.019). Conclusions: This is the largest nationwide study of DOAC-associated ICH in a real-world situation in Japan, revealing that the patients with DOAC-associated ICH had better clinical outcomes compared with warfarin-associated ICH, probably due to milder hemorrhage at admission.

scholarly journals Association of liver cirrhosis severity with type 2 diabetes mellitus in hepatocellular carcinoma

2017 ◽  
Vol 243 (4) ◽  
pp. 323-326
Author(s):  
Ankita Makol ◽  
Shruthi Kanthaje ◽  
Radha K Dhiman ◽  
Naveen Kalra ◽  
Yogesh K Chawla ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hepatocellular Carcinoma ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Cirrhosis ◽  
Risk Factor ◽  
Liver Disease ◽  
Prior History ◽  
Number Of Patients

Type 2 diabetes mellitus (T2DM) is a major risk factor associated with hepatocellular carcinoma (HCC). However, the association of T2DM with liver cirrhosis and therapy response in HCC patients is not clear. Hence, in this study, we have evaluated the influence of T2DM on liver cirrhosis severity of HCC and sorafenib response. HCC patients were divided in two groups: T2DM (n = 20) and non-T2DM (nT2DM; n = 50). We found significantly higher number of patients in T2DM group had decompensated liver disease with Child–Turcotte–Pugh score ≥ 7. Additionally, 71.4% patients were observed to be sorafenib sensitive in T2DM group which was significantly higher as compared to 30% in nT2DM group. This study has highlighted the predisposition of HCC patients with T2DM toward more severe liver disease who were found to be better respondents of sorafenib. Impact statement We have explored the association of type 2 diabetes mellitus (T2DM) on liver cirrhosis severity along with response toward sorafenib in hepatocellular carcinoma (HCC). Most HCC patients exhibit prior history of liver cirrhosis that results following long span of chronic liver disease. T2DM constitutes as an important risk factor for HCC development which is known to elevate its incidence. Further, sorafenib is the FDA approved therapy for HCC whose therapeutic outcome is not investigated in HCC patients with T2DM till date. This observation-based study has unveiled a positive association between T2DM and severity of liver cirrhosis as well as sorafenib response in HCC as examined in a clinical setting.

scholarly journals Hepatocellular Carcinoma in Oman: An analysis of 284 cases

2020 ◽  
Vol 20 (3) ◽  
pp. 316
Author(s):  
Khalid Al-Naamani ◽  
Zamzam Al-Hashami ◽  
Omar Al-Siyabi ◽  
Mansour Al-Moundri ◽  
Bassim Al-Bahrani ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Viral Hepatitis ◽  
Tertiary Care ◽  
Case Series ◽  
Liver Tumour ◽  
Alpha Fetoprotein ◽  
Treatment Modalities ◽  
Surveillance Programme ◽  
Case Series Study

Objectives: Hepatocellular carcinoma (HCC) is the most common type of primary liver tumour worldwide and is increasing in incidence. This study aimed to describe the clinical characteristics of HCC among Omani patients, along with its major risk factors, outcomes and the role of surveillance. Methods: This retrospective case-series study was conducted between January 2008 and December 2015 at the three main tertiary care hospitals in Oman. All adult Omani patients diagnosed with HCC and visited these hospitals during the study period were included. Relevant data were collected from the patients’ electronic medical records. Results: A total of 284 HCC patients were included in the analysis. The mean age was 61.02 ± 11.41 years and 67.6% were male. The majority had liver cirrhosis (79.9%), with the most common aetiologies being chronic hepatitis C (46.5%) and B (43.2%). Only 13.7% of cases were detected by the HCC surveillance programme. Approximately half of the patients (48.5%) had a single liver lesion and 31.9% had a liver tumour of >5 cm in size. Approximately half (49.2%) had alpha-fetoprotein levels of ≥200 ng/mL. The majority (72.5%) were diagnosed using multiphase computed tomography alone. Less than half of the patients (48.9%) were offered one or more HCC treatment modalities. Conclusion: The majority of Omani HCC patients were male and had cirrhosis due to viral hepatitis. In addition, few patients were identified by the national surveillance programme and presented with advanced disease precluding therapeutic or even palliative treatment.Keywords: Hepatocellular Carcinoma; Liver Cirrhosis; Human Viral Hepatitis; Public Health Surveillance; Early Detection of Cancer; Alpha-Fetoprotein; Oman.

Sign in / Sign up

Export Citation Format

Share Document